FDG PET/CT对经典型不明原因发热的诊断价值  

Value of ^(18)F-FDG-PET/CT in diagnosis of classic fever of unknown origin

作　　者：赵葵[1] 董孟杰[1] 阮凌翔[1] 刘振锋[1] 杨树业[1] 王国林[1] 孙芳[1] 

机构地区：[1]浙江大学医学院附属第一医院PET中心,浙江杭州310003

出　　处：《浙江大学学报（医学版）》2010年第2期174-180,共7页Journal of Zhejiang University(Medical Sciences)

基　　金：浙江省科技厅基金资助项目(2009C33109);浙江省医药卫生基金资助项目(2007A072)

摘　　要：目的:探讨FDG PET/CT在经典型不明原因发热中的诊断价值。方法:对在2007年10月至2009年10月间27例(男性19例,女性8例)经典型不明原因发热病例,行FDG PET/CT显像,PET/CT图像结果判断应用目测法和半定量分析方法。最终诊断包括病理学检查或临床随访。结果:纳入本研究共27例不明原因发热患者,行PET/CT检查后经病理穿刺或病例随访证实,引起不明原因发热的病因共21例,其中包括感染10例,肿瘤性疾病(淋巴瘤)4例,非感染性炎症4例,其他类型3例,未能发现病因6例。FDG PET/CT诊断真阳性21例,假阳性1例,假阴性0例,真阴性5例。灵敏度100%,特异性83.3%;阳性预测值95.5%,阴性预测值100%;准确性96.3%。结论:在诊断不明原因发热患者中,FDG PET/CT显像是灵敏可靠的诊断方法,建议常规检查未能发现病灶或不能确诊的病例,可尽早行FDG PET/CT显像。Objective： To evaluate the application of 18F-FDG PET/CT in diagnosis of classic fever of unknown origin.Methods： A total of 27 consecutive patients with classic fever of unknown origin（FUO）（19 men,8 women;aged 24-82 y） underwent 18F-FDG PET/CT scans.The images were interpreted by visual inspection and semiquantitative analysis（standardized uptake value,SUV）.Final diagnosis was based on histopathology or clinical follow-up.Results： The cause of FUO was confirmed by followed investigations in 21 of 27 cases after PET/CT scan,including 10 cases of infection,4 of noninfectious inflammation,4 of malignancies and 3 of miscellaneous disorders;and remaining 6 cases were still confirmed FUO.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 100.0%,83.3%,83.3%,100.0% and 96.3%,respectively.Conclusion： For patients with fever of unknown origin,18F-FDG-PET/CT can be a sensitive,reliable imaging modality.It is suggested that 18F-FDG-PET/CT should be considered earlier in detecting the causes of FUO,which is difficultly diagnosed by conventional modalities.

关 键 词：发热 原因不明/诊断 发热 原因不明/病理学 氟脱氧葡萄糖F18 正电子发射断层显像术 体层摄影术 X线计算机 随访研究 

分 类 号：R817.4[医药卫生—影像医学与核医学]